| Stephanie Buckley Licsw Llc | |
|
20 Spring Hill Rd East Sandwich MA 02537-1068 | |
| (774) 313-0217 | |
| Not Available |
| Full Name | Stephanie Buckley Licsw Llc |
|---|---|
| Speciality | Counselor |
| Location | 20 Spring Hill Rd, East Sandwich, Massachusetts |
| Authorized Official Name and Position | Stephanie Buckley (OWNER) |
| Authorized Official Contact | 7743130217 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Buckley Licsw Llc Po Box 403 Sandwich MA 02563-0403 Ph: (774) 313-0217 | Stephanie Buckley Licsw Llc 20 Spring Hill Rd East Sandwich MA 02537-1068 Ph: (774) 313-0217 |
| NPI Number | 1336860386 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Medicare PECOS PAC ID | 4789055732 |
|---|---|
| Medicare Enrollment ID | O20230130002029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336860386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Stephanie Buckley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548744824 PECOS PAC ID: 7315318367 Enrollment ID: I20230131001350 |
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